The San Bruno blast: Let’s call it a N.E.W. day

The San Bruno blast sure puts a lot in perspective, doesn’t it? If you, too, are tired of the frenzy over Quran-burning threats and counter threats, maybe the tragedy of this blast got you, like me, painfully re-focused on the people who lived and died on 9-11. The people who were victims and the workers who risked, and sometimes gave, their lives for others when tragedy struck.

Don’t get me wrong. I’m mad too. Like Terry Jones, I, personally, would like to burn something right now. I’d like to burn every bit of coverage wasted on catering to the worst of human nature. I’d like to build a giant bonfire out of it and then, if it’s still kicking, ignore it to death. When disasters like the San Bruno blast destroy lives, I’d personally like, instead, to have us all shift just a wee bit of our attention toward the best of human nature that is often manifest in only the worst of tragedies.

What am I talking about? I’ve been in emergency rooms and around ambulances enough to know a bit of what it might have been like last evening in San Bruno. Not all the details – just an echo. But even that is enough to make my palms sweat.

Imagine the entire chain of human activity. The firefighters who drove straight toward the blaze, even as the tower rose higher and higher to engulf the very sky, knowing this was something no one with a hose and a truck could stop or even contain. The sweat and the sizzle as you run from one paint-bubbling house to the next, imagining the screams of children as you knock and yell and draw an X on one house, only to sprint, heart pounding, to the next. Flames flicker and lick and you think, “God, let the other rigs come.” And then they do – rigs from other counties, people who were supposed to be sitting down to supper, firefighters who’ve never even driven these streets. Sixty-seven trucks came. Just think about that for a moment. No ego, no jurisdictional posturing, no hemming and hawing about budgets or how the assignment ought go to someone else, someone closer. All those teams, all those men and women, strapping on heavy gloves and helmets and feeling the claustrophobia and vertigo of wind whipping past as you accelerate onto a freeway in an open firetruck, the straining rumble of the screaming RPMs making your stomach shake. Then you hit the ground and ask, “what can I do?” and you join in, the sprint, the yell, the heavy lifting and the search, the endless search even now, the day after, through embers, dreading what you might find, what will give you nightmares for decades to come. And when you get home, and wipe the ash from your neck, you cough up soot and look at it, hoping your lungs are tougher than average because you’ve been in this, you’ll stay in this, for the long haul.

A heartbeat later are the paramedics – men and women who fly through streets to the deafening scream of their sirens shrieking and shrieking out the need to hurry hurry. There are only so many rigs, and you’re in one of them and still you have to wait, bouncing on the edge of your seat, waiting for the fire chief to tell you where to go, whether or not your street is likely to be engulfed in flames if the wind changes and you’re not really listening because you know, the way only someone trained to the bone from years of experience seeing the worst that can happen day after day – you KNOW that someone’s dying out there. Right now. Someone you could maybe save. Time is life and it’s ticking away. They let you through and doors fly open, you grab your kit and then you see your first person, eyes open to the sky, lying on the flecked, overheated concrete and everything’s a blur, hands ripping apart cello-wrapped packages and bandages unsnaking and oxygen masks hissing a warning in the oven-hot air. Then you’re lifting and grimacing as you try to ignore the pain and the smells and the horrors and you blink hard as you murmur, “it’ll be okay, we’re going to get you to the hospital now.” There’s the constant crackle and bleep of the radio as your base station barks “what’ve you got?” and you talk to your shoulder giving the coded bullet point summary that makes your throat tighten because it doesn’t even BEGIN to cover the depth of human misery you’re carrying in your arms. And you wonder if you can get two people in your rig even though there’s no room, but how can you leave a person behind and you find yourself thinking, “oh God, will some others come?” And then they do – ambulances streak in from all over, flying in like a reverse explosion of red vehicles along city streets heading into the blast area and you know that there’ll be men and women standing in the backs of the fat RV red-painted shapes as they screech and sway, flying through dangerous intersections and then you’re one of them, on your way out holding a harpoon-sized needle in your hand, nailing it in a vein first try with a finesse that you don’t even see any more. Because you’re thinking ahead, getting the morphine going and, just as importantly, you force yourself to say the words of hope and encouragement and you keep your face stiff as you say them, knowing how bad it is, knowing how this one’s going to stay with you, images coming back to visit you when your guard is down and your mind lets go in sleep, or when the acrid smells of burning plastic or diesel sneak up on you some day in the future. The rig lurches and you know your partner is turning off, heading to the closest ER and you hope to God they’re ready for you and all the many others like you. The ones who’ve come, the ones at your back.

The ER knows. The ER always knows. Word goes out over EMS and nurses run and residents pound down stairs and patients are wheeled out to other rooms, machines unhooked and phone calls made come in come in come in, we’ve got a disaster no we don’t know how many come down, get the OR cleared call the blood bank O neg I hear it’s burns. All hands are on deck and no they’re not Kaiser patients but it’s Kaiser they go to because it’s closest and in an instant everyone pitches in, nurses tear tape with teeth lining up strips along a rail even before a patient arrives, respiratory therapists are running with vents along hallways leaning forward and pushing them ahead, poles and bags are hung in every corner, tubes swaying like pale vines, the air is filled with the jerk and clank of equipment and muffled shouts of “Peds? Who’s on peds?” and the clerks are already calling and calling and talking to families, phone cradled in a shoulder hands reaching for forms, standing to grab labels and wristbands and slap them together. There’s a moment before the first patient hits the door, the air more oppressive than the eye of a tornado, an eerie quiet and then the twin electric doors whoosh open and nurses are flying with equipment, hands popping syringes and needles whipping up and down into bags and tubes and rubber gaskets without pause, and the rip of velcro from blood pressure cuffs growls and growls and wheels creak and clog-soles thump as someone is running with oxygen canisters and over it all is a weird calm, a frenzied dance where sometimes a person bumps as they reach for the same gloves but no one pauses they move and twirl and lift and grab ampules and you wipe your forehead above your mask with your forearm, bellowing for someone over here to give a hand and the charge nurse stalks from room to room, shifting a nurse here, moving an aide there, balancing the numbers because you know it’s going to be bad. And you think, “oh God, let’s hope another facility can take some…” and then they do.

Last night airwaves crackled and patients were zipped from facility to facility and lives were saved and no one talked about coverage or reimbursement or personal safety or assignments or anything but how best to save someone, how best to ease the suffering and you felt what it was like, why you went into medicine in the first place, why you stuck with it all those years despite all the negatives. And you flew, your hands literally flew as you wrote orders and started fluids and calculated body surface areas and cell-phoned over and over until finally report was given and you could help push the gurney out into the elevator for the ICU. You gently moved a slack, IV’d hand from the edge of the cot-thin mattress where it lay, vulnerable, because you couldn’t stand the thought that, on top of all this suffering, suffering already borne, suffering you just inflicted to save a life, suffering still to come, you couldn’t stand the thought that this slack, curled hand might get bumped on the journey up. And you hitch up your scrubs and head back, to start again, to put a needle in another hand, this one smaller, even though it’s six hours after your 12 hour shift should have ended.

So I just want to ask – as our hearts and thoughts go out to all the families who’ve suffered, can’t we please, also, for the next 24 hours, call it a N.E.W. day? A National Emergency Workers’ Day? Even if they weren’t personally in San Bruno, or in New York for 9-11, how about if we drop a batch of cookies by a station house? How about if we buy a $5 gift card and hand it to a paramedic on break? How about if we take a to-go box of coffee by the Kaiser ER? Because for me, personally, when tragedies like this one strike, I’d rather show a little love and spend my time and energy honoring the best of us, the ones who’ve stepped up and gone beyond what anyone could reasonably expect. Those moments when the system works and quiet heroes emerge. If you feel this way too, share it on Facebook, tweet it to friends, spread it around.

Got a person to honor? Or do you think the idea is just another bogus PR trick? Sound off in the comments section. Are you a fan? You can follow Doc Gurley on Facebook. Doc Gurley is the only Harvard Medical School graduate, ever, to be awarded the coveted Shoney’s Ten Step Pin for documented excellence in waitressing, and is a practicing board-certified internist. You can get more health posts at www.docgurley.com, or jump on the Twitter bandwagon and follow Doc Gurley. Also check out Doc Gurley’s joyhabit and iwellth twitter feeds – so you can get topic-specific fun, effective, affordable tips on how to nurture your joy and grow your personal wellth.